Global Spine Range of Motion in Patients With Adolescent Idiopathic Scoliosis Before and After Corrective Surgery.

Abstract

Given the importance of the spine in carrying out daily movements, adolescent idiopathic scoliosis (AIS) can significantly limit the range of motion (ROM). Severe forms of AIS are treated surgically, most commonly with posterior spinal fusion and instrumentation, which may also reduce spine ROM. This review is the first to describe the literature on total spine ROM in patients with AIS before and after corrective surgery. A systematic literature search was performed using PubMed and Google Scholar to identify articles reporting global spine ROM in AIS patients. Following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 486 articles were initially identified. Two independent reviewers (YM and JH) assessed eligibility for inclusion.A total of 11 articles fit the inclusion criteria. AIS in untreated patients seems to limit axial and coronal plane ROM based on the degree of curve severity, with more severe curves having less ROM. More research comparing total spine ROM in untreated AIS patients to that of healthy controls is needed. In those undergoing spinal fusions, the lowest instrumented vertebra and surgical approach appear to minimize further reductions in ROM; however, the findings are mixed. Vertebral body tethering (VBT) shows promising preliminary results in treating AIS while preserving motion; however, long-term outcomes have yet to be assessed for this novel procedure. The results of this systematic review suggest that further research is required before treatment strategies can be modified for surgically treating patients with AIS to take into account the effects of treatment on changes in spine mobility.